Person: Neria Serrano, Fernando
Loading...
First Name
Fernando
Last Name
Neria Serrano
Affiliation
Faculty
Medicina
Department
Area
Identifiers
11 results
Search Results
Now showing 1 - 10 of 11
Item Access to liver transplant for women in Spain: a national registry analysis.(Journal of Hepatology, 2023) Tejedor Bravo, Marta; Neria Serrano, Fernando; De la Rosa, Gloria; Almohalla Alvarez, Carolina; Boscá, Andrea; Fundora, Yilliam; Sánchez-Bueno, Francisco; Berenguer, MarinaBackground and aims: Gender inequities in liver transplantation (LT) have been documented recently in several studies. Providing national data is crucial as poorer access to liver transplantation for women than men might be explained by different analytical approaches or different national contexts. Our aim was to describe the recipient profile over time in Spain, particularly regarding potential sex-related differences in access to LT. Method: All adult patients registered in the RETH-Spanish Liver Transplant Registry from 2000 to 2018 for LT were included. Baseline demographics, presence of hepatocellular carcinoma (HCC), cause and severity of liver disease, time on the waiting list (WL), access to transplantation, and reasons for removal fromthe WL were assessed. Results: 9427 patients were analyzed (77.6% men, 55.3 ± 8.6 years of age). Mean MELD score was reported for 3404 patients (36.1%), and was 16.5 ± 5.8. Women were less likely to receive a transplant than men (OR 0.84, 95% CI 0.73, 0.97) and more likely to be excluded for deterioration (HR 1.21, 95% CI 1.02, 1.44), despite similar liver disease severity (MELD score 16.6 ± 5.8 vs 16.5 ± 5.8 respectively, N.S) and only a slightly longer mean time on the WL (244 ± 398 days for women vs 213 ± 324 for men, p = 0.001). In recent years, this difference in access to LT was less significant (before 2011 women’s HR for exclusionwas 1.51 [95% CI 1.01, 2.26] vs 1.17 [95% CI 0.97, 1.41] after 2011) and could be attributed to overall shorter mean WL times after 2011 (398 ± 602 vs 154 ± 217 days respectively, p < 0.001). When analyzed by MELD, WL times were similar by sex for patients with scores under 16 or above 20, but women had significantly longer mean WL times than men with MELD scores 16–20 (270 ± 267 vs 211 ± 207 days respectively, p < 0.001). Women were shorter (170.5 ± 9.7 vs 158.5 ± 9.8 cm) but had a similar BMI compared to men. Inwomen, the main indications for transplant were cholestatic liver diseases, autoimmune hepatitis and NASH, whilst in men it was alcohol (p < 0.001). Women had less HCC than men (27.1 vs 16.6%, p < 0.001). Conclusion: Shorter WL times contribute to a more equal access to LT by sex, as it prevents women from deteriorating while waiting and therefore being excluded from the list.Item Reply to pre hospital interventions and organ donation in out of hospital cardiac arrest.(Resuscitation, 2023) Rubio Chacón, Carlos; Mateos Rodríguez, Alonso; Neria Serrano, Fernando; Del Río Gallegos, Francisco; Andrés Belmonte, AmadoItem A Paradoxical Clinical Coincidence: Benign Paroxysmal Positional Vertigo and Bilateral Vestibulopathy.(Journal of Clinical Medicine, 2023) Pérez Fernández, Nicolás; Saez Coronado, Sara; Zulueta-Santos, Cristina; Neria Serrano, Fernando; Rey-Martinez, Jorge; Blanco, Melisa; Manrique-Huarte, RaquelBenign paroxysmal positional vertigo (BPPV) and bilateral vestibulopathy (BVL) are two completely different forms of vestibular disorder that occasionally occur in the same patient. We conducted a retrospective review searching for that coincidence in our database of the patients seen over a 15-year period and found this disorder in 23 patients, that is 0.4%. More frequently they occurred sequentially (10/23) and BPPV was diagnosed first. Simultaneous presentation occurred in 9/23 patients. It was subsequently studied, but in a prospective manner, in patients with BPPV on all of whom a video head impulse test was performed to search for bilateral vestibular loss; we found it was slightly more frequent (6/405). Both disorders were treated accordingly, and it was found that the results follow the general trend in patients with only one of those disorders.Item Incidence, risk factors, and evolution of venous thromboembolic events in patients diagnosed with pancreatic carcinoma and treated with chemotherapy on an outpatient basis.(European Journal of Internal Medicine, 2022) García Adrián, Silvia; Neria Serrano, Fernando; Muñoz Martín, Andrés J.Background Pancreatic carcinoma is one of the tumors associated with a higher risk for thromboembolic events, with incidence rates ranging from 5% to 41% in previous retrospective series. Patients and methods We conducted a retrospective study in eleven Spanish hospitals that included 666 patients diagnosed with pancreatic carcinoma (any stage) between 2008 and 2011 and treated with chemotherapy. The main objective was to evaluate the incidence of venous thromboembolic events (VTE) in this population, as well as potential risk factors for thrombosis. The impact of VTE on mortality was also assessed. Results With a median follow-up of 9.3 months, the incidence of VTE was 22.1%; 52% were diagnosed incidentally. Our study was unable to confirm the ability of the Khorana score to discriminate between patients in the intermediate or high risk category for thrombosis. The presence of VTE proved to be an independent prognostic factor associated with increased risk of death (HR 2.39, 95% CI 1.96–2.92). Symptomatic events correlated with higher mortality than asymptomatic events (HR 1.72; 95% CI, 1.21–2.45; p = 0.002), but incidental VTE, including visceral vein thrombosis (VVT), negatively affected survival compared to patients without VTE. Subjects who developed VTE within the first 3 months of diagnosis of pancreatic carcinoma had lower survival rates than those with VTE after 3 months (HR 1.92, 95% CI 1.30–2.84; p<0.001). Conclusions Pancreatic carcinoma is associated with a high incidence of VTE, which, when present, correlates with worse survival, even when thrombosis is incidental. Early onset VTE has a particularly negative impact.Item Influence of donor capnometry on renal graft evolution in uncontrolled donation after circulatory death.(Resuscitation, 2023) Rubio Chacón, Carlos; Mateos Rodríguez, Alonso; Neria Serrano, Fernando; Del Río Gallegos, Francisco; Andrés Belmonte, AmadoAim To analyse the association between donor capnometry data and the short-term evolution of kidney grafts in cases of uncontrolled donation after circulatory death (uDCD). Method We used an ambispective observational study design, conducted in the Community of Madrid between January and December 2019, inclusive. Patients who suffered out-of-hospital cardiac arrest (CA) with no response to advanced cardiopulmonary resuscitation (CPR) were selected as potential donors. Donor capnometry levels were measured at the start, midpoint and transfer to hospital then compared with indicators of renal graft evolution. Results The initial selection included 34 possible donors, of which 12 (35.2%) were viable donors from whom 22 (32.3%) kidneys were recovered. There was a correlation between the highest capnometry values and less need for post-transplant dialysis (≥24 mmHg, p < 0.017), fewer dialysis sessions and fewer days to recover correct renal function (Rho −0.47, p < 0.044). There was a significant inverse correlation between the capnometry values at transfer and 1-month post-transplant creatinine levels (Rho −0.62, p < 0.033). There were no significant differences between the capnometry values at transfer and primary nonfunction (PNF) or warm ischaemia time. One-year patient survival was 100% for patient receiving organ donation, while graft survival was 95%. Conclusions Capnometry levels at transfer are a useful predictor of the short-term function and viability of kidney transplants from uncontrolled donations after circulatory death.Item General infection prevention, mitigation, and control procedures implemented in the university education during the COVID-19 pandemic to achieve classroom attendance: a successful community case study.(Frontiers in Public Health, 2024) Monge Martín, Diana; Gallego Gil, Ana; Neria Serrano, Fernando; Canellas, Soledad; Caballero Martínez, Fernando; Díaz de Bustamante, Ana; Samper, MónicaIntroduction: The COVID-19 pandemic entailed confinement and elimination of face-to-face university classes in Spain. The Francisco de Vitoria University in Madrid (UFV by its Spanish acronym) implemented risk management systems to enable on-campus university activity to avoid a negative impact on students, teachers, and faculties. Methods: A tracking/registry system was implemented to collect data, identify COVID-19-related cases, implement containment measures, and do follow-up in the UFV community (administration/services personnel [ASP], teaching/research personnel [TRP], and students), from September 2020 to April 2022. In addition, a prevention plan was implemented on campus to avoid COVID-19 spreading. Satisfaction with these measures was assessed through an online questionnaire. Results: A total of 7,165 suspected COVID-19 cases (84.7% students, 7.7% ASP, 6.5% TRP) were tracked (62.5% female cases, mean age (±SD) 24.8 years (±9.2 years)), and 45% of them confirmed (82% symptomatic/16% asymptomatic), being the student group that with the highest percentage (38.3% total tracked cases). The source of infection was identified in 50.6% of the confirmed cases (90.2% located off-campus). Nineteen COVID-19 outbreaks were registered (inside-10/outside-9). COVID-19 incidence rates were similar or lower than those reported in the Community of Madrid, except in the last wave, corresponding to Omicron variant. The degree of satisfaction (scale 1–6) with the implemented measures was high (scores 4.48–5.44). Conclusion: During the COVID-19 pandemic, UFV control measures, periodic monitoring, and the effectiveness of the tracking system have contributed to maintaining classroom teaching, guaranteeing health and safety. UFV has adapted to a new reality as an example of good practice for future pandemics or emergency situations.Item Concordancia competencial entre el Examen Clínico Objetivo Estructurado y la prueba de casos clínicos computarizados de Medicina: ¿estamos evaluando lo mismo?.(Educación Médica, 2023) Cervera Barba, Emilio; Blanco Canseco, José Manuel; Fidalgo-Montero, Pilar; Gámez-Cabero, M. Isabel; Hijano-Bandera, Francisco; Holgado-Catalán, M. Soledad; Salinas Gabiña, Irene; Neria Serrano, Fernando; Castañeda-Vozmediano, Raul; Denizon-Arranz, SophiaIntroducción en el curso 2020-21 las facultades de Medicina españolas realizaron una evaluación con casos-clínicos computarizados (denominada ECOE-CCS) y algunas, además, una ECOE convencional con simuladores y pacientes simulados (ECOE-CS). El Comité ECOE interfacultativo asumió como iguales las competencias evaluadas con ambas pruebas. El objetivo del estudio es comprobar su similitud valorando la concordancia de resultados de alumnos en las competencias evaluadas con las 2 pruebas. Métodos ciento ocho alumnos participaron en la ECOE-CCS de 10 casos clínicos y una ECOE-CS de 12 estaciones. Hubo 2 versiones de ECOE-CS para disminuir el efecto copiado entre alumnos. La ECOE-CCS tuvo 303 ítems de evaluación, y las ECOE-CS 320 y 321 ítems respectivamente. Los 5 dominios competenciales evaluados con ambas pruebas fueron: anamnesis, exploración clínica, juicio clínico, prevención y profesionalismo. La consistencia interna de ambas ECOE se midió con el alfa de Cronbach. La correlación entre dominios competenciales se testó con el coeficiente de correlación de Pearson (R). Resultados los alumnos obtuvieron medias de calificaciones globales similares en ambas pruebas (ECOE-CS: 69,54%; ECOE-CCS: 71,35%). Hubo diferencias significativas en 4 de 5 dominios competenciales evaluados por ambas pruebas. La consistencia interna respecto a sus dominios competenciales fue: ECOE-CS-1 α = 0,62; ECOE-CS-2 α = 0,54 y ECOE-CCS α = 0,38. No se halló correlación entre calificaciones globales de alumnos en las 2 pruebas (R = 0,184; p = 0,056), ni entre los dominios competenciales similares evaluados con ambas (R = -0,2 a 0,37). Conclusión los resultados no avalan la similitud de competencias evaluadas con ambas pruebas. Serán necesarios otros estudios para definir las competencias evaluadas con la ECOE-CCS.Item Poppers maculopathy: A quantitative review of previous literature.(Seminars in Ophthalmology, 2021) González Martín-Moro, Julio; Guzmán Almagro, Elena; Ventura Abreu, Néstor; Neria Serrano, FernandoAim To review the available literature on poppers maculopathy (PM). Material and methods Sixty-four patients (60 with bilateral and 4 with unilateral involvement), for a total of 124 eyes were reported in PubMed, Google Scholar and Embase. Patterns were analyzed according to country, age, gender, sexual orientation, HIV status, consumption habits, visual acuity at presentation (VAP), final visual acuity (VAF) and optical coherence tomography (OCT). Results Most cases (110 eyes) of PM were reported in European countries and affected middle-aged men (only 8 eyes from female users). The median age was 38.7 years (SD = 10.5 years). Final visual acuity (Median = 0.8; Interquartile range: 0.67–1) was higher than visual acuity at presentation (Median = 0.67; Interquartile range: 0.4–0.8). Many articles lack data on sexual orientation and HIV status as this is considered very personal information. One third of the eyes (40 eyes) developed PM after a single exposure. No significant differences were found between eyes that developed PM after a single exposure and those which developed the condition after several exposures. The most commonly reported pattern was an interruption of the ellipsoid line (68 eyes). Conclusion PM is more prevalent in Europe or European ophthalmologists are more likely to diagnose PM. PM usually affects middle-aged men given that this condition generally appears with chronic exposure to poppers. VAF was higher than VAP, suggesting that this toxicity is in part reversible. Information about HIV status was not provided in most recent articles, thus it is not possible to make inferences about the possible implication of HIV drugs as cofactors for the development of this retinal toxicity.Item A Multifaceted Educational Intervention in the Doctor–Patient Relationship for Medical Students to Incorporate Patient Agendas in Simulated Encounters.(Healthcare, 2023) Denizon-Arranz, Sophia; Monge Martín, Diana; Caballero Martínez, Fernando; Neria Serrano, Fernando; Chica Martínez, Patricia; Ruiz Moral, RogerFrom the beginning of their clinical training, medical students demonstrate difficulties when incorporating patient perspectives. This study aimed to assess if students, after an instructional programme, increased their sensitivity towards patients’ needs and carried out bidirectional conversations. An observational study involving 109 medical students prior to their clerkships was designed. They attended a five-step training programme designed to encourage the use of communication skills (CSs) to obtain patients’ perspectives. The course developed experiential and reflective educational strategies. The students improved their use of CSs throughout three sessions, and the overall score for these patient consultations went up in the opinions of both the external observer (EO) (5; 6.6; 7.5) and the simulated patients SPs (5.3; 6.6; 7.8). Most of the students (83.9%) considered that the CSs addressed were useful for clinical practice, particularly the interviews and the feedback received by the SP and the lecturer. The programme seems to help the students use CSs that facilitate a more bidirectional conversation in a simulated learning environment. It is feasible to integrate these skills into a broader training programme. More research is needed to assess whether the results are applicable to students in real settings and whether they influence additional outcomes.Item Impact of different waves of COVID-19 on emergency medical services and out-of-hospital cardiopulmonary arrest in Madrid, Spain(World Journal of Emergency Medicine, 2022) Navalpotro-Pascual, Jose-María; Monge Martín, Diana; González León, Manuel-José; Neria Serrano, Fernando; Alonso Blas, Carlos; Muñoz Isabel, Belén; Muñecas Cuesta, Yago; Carrillo Moya, Alfredo; Les González, Juan; Mateos Rodríguez, AlonsoOut-of-hospital cardiac arrest (OHCA) is one of the three leading causes of death in industrialized countries.[1,2] Some studies have described the impact of the first COVID-19 pandemic wave in terms of the number of cases and OHCA survival rates in various regions,[3-5] but few have addressed the relationship between the successive phases and how they affected OHCA.[6,7] The 14-d cumulative incidence peaked at more than 990 cases, with these rates remaining above 200 for an eight-month period between 15 March 2020 and 15 March 2021 in Madrid, Spain. The objectives of the current study were twofold. First, we sought to describe how the different waves in the first pandemic year aff ected the healthcare activity of the Spanish emergency medical services (EMS). Second, we compared effects of the pandemic year on OHCA care to those of the preceding non-pandemic year in terms of initiating cardiopulmonary resuscitation and survival in a community with a high incidence of COVID-19.